Facility Evaluation Report

On 01/07/2025, at 09:00 AM, Licensing Program Analyst (LPA) Melody Brown conducted an announced visit to the facility for the purpose of a Prelicensing Visit. LPA Brown met with Applicant/Administrator Czarina Arboleda and Applicant Archie Arboleda. An initial application for license to operate a Residential Care for the Elderly facility (RCFE) was submitted to the Central Applications Bureau (CAB) on 05/20/2024 for a total capacity of six (6). Fire clearance was granted on 06/24/2024 for six (6) non-ambulatory residents. LPA Brown observed the following:

Facility was a one (1) level house with four (4) bedrooms, two (2) resident/staff bathrooms, living room, dining area, laundry room and kitchen. There is an attached two (2) car garage.

Central heating and air conditioning system installed with a central panel located in the hallway to control the entire house.

Each resident bedrooms accommodate any non-ambulatory resident. All resident bedrooms were adequately furnished with bed, chair, closet, appropriate linens, adequate lighting, and an operable smoke and carbon monoxide alarm.

The two (2) staff/resident bathrooms have a working toilet, wash basin, and shower with an adequate supply of toilet paper and soap. At 09:45 AM, LPA Brown tested the water temperature in the resident bathrooms. LPA verified water temperature was measured at 110.6 degrees Fahrenheit.